Anatomical Basis of Hypoglossal Nerve Palsy

Clinical Presentation and Symptoms

The hypoglossal nerve (cranial nerve XII) plays a crucial role in controlling tongue movements. Dysfunction of this nerve leads to hypoglossal nerve palsy, resulting in impairments in speech, swallowing, and tongue mobility.

Anatomy of the Hypoglossal Nerve

• The hypoglossal nerve originates from the hypoglossal nucleus in the brainstem.
• It exits the skull via the hypoglossal canal.
• Innervates the intrinsic and extrinsic muscles of the tongue.

Etiology and Causes

Hypoglossal nerve palsy can arise due to various pathological conditions, including:

1. Stroke affecting the brainstem
2. Compression due to tumors or vascular abnormalities
3. Traumatic injuries affecting the hypoglossal canal
4. Neurodegenerative conditions

Clinical Symptoms and Diagnosis

Common symptoms associated with hypoglossal nerve palsy include:

• Deviation of the tongue toward the affected side
• Atrophy and fasciculations in tongue muscles
• Difficulty in articulation and speech
• Impaired swallowing (dysphagia)

Diagnosis typically involves neurological examinations, imaging studies (MRI, CT), and electromyography.

Treatment Options

Treatment for hypoglossal nerve palsy depends on the underlying etiology:

• Physical therapy for tongue exercises
• Speech therapy for articulation improvements
• Surgical interventions for tumors or vascular anomalies
• Medical management for infections or inflammation